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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. LAO 0797710
Regular
Apr 21, 2008

LEONARD DI PERI vs. INTERNET CONNECT, ST. PAUL TRAVELERS SPECIAL SERVICES

This case involves an applicant who sustained an admitted industrial back injury in 2000. The Workers' Compensation Appeals Board denied reconsideration of a prior award, affirming the applicant's entitlement to temporary disability indemnity. The Board found that the applicant was properly allowed an expedited hearing on retroactive TDI, and rejected the defendant's claims of due process denial and unjust enrichment due to delayed surgery.

Expedited hearingretroactive temporary disability indemnitydue processunjust enrichmentspinal surgery authorizationmedical evaluation cancellationadmitted industrial injuryLabor Code section 5502priority calendarvocational rehabilitation
References
Case No. ADJ7447035; ADJ7447437
Regular
Mar 25, 2019

BERTHA PEREZ vs. WORLD VARIETY PRODUCE, INC., ZURICH INSURANCE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the prior order, remanding the case for further proceedings. The WCAB found that the original decision lacked sufficient evidence to support findings regarding restitution and sanctions against the lien claimant. Specifically, there was no admitted evidence proving unjust enrichment, fraud, or improper conduct by the lien claimant. Similarly, the record was insufficient to determine if the lien claimant engaged in bad faith tactics or frivolous delays warranting sanctions.

Lien claimantReconsiderationRestitutionUnjust enrichmentSanctionsFrivolous tacticsDiscoveryBill reviewWCJAppeals Board
References
Case No. ADJ197931
Regular
Oct 07, 2008

GENE DEL MASTRO vs. JOHN MANNINGER ELECTRIC, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board ruled that a lien claimant, Implantium, LLC, has standing to bill for surgical implants even if they are not covered by the Official Medical Fee Schedule (OMFS), as employer liability under Labor Code section 4600 is not limited to OMFS-covered services. The Board also found that Implantium's failure to file a fictitious business name statement until after providing services does not preclude reimbursement, as the statute only requires such filing to maintain an action, not for services rendered. Finally, the Board affirmed the consolidation of cases and deferred the issue of unjust enrichment for further proceedings.

Workers' Compensation Appeals BoardState Compensation Insurance FundSCIFImplantiumLLClien claimantOfficial Medical Fee ScheduleOMFSunjust enrichmentlicensing
References
Case No. ADJ1786826 (LAO0772803)
Regular
Sep 23, 2022

MICHAEL GUTIERREZ vs. ALPHA FOX TOWING COMPANY, STATE COMPENSATION INSURANCE FUND

This case concerns a dispute over $\$ 30,000$ in attorney's fees awarded to a former attorney. The applicant's current attorneys sought reconsideration of the Workers' Compensation Judge's order compelling them to pay this amount from the $\$ 180,000$ attorney fee approved in a settlement. The Board denied the petition, finding the WCJ properly allocated the fee, deeming the $\$ 30,000$ a reasonable portion of the total fee for the former counsel's services. The Board emphasized that attorney fees are subject to the Board's determination of reasonableness and that current counsel was unjustly enriched by attempting to retain the entire fee.

WCABPetition for ReconsiderationFindings and Orderattorney's feesformer counsellien claimantCompromise and ReleaseState Compensation Insurance FundOrder Approving Compromise and Releaseunjust enrichment
References
Case No. ADJ1818368 (VNO 0523027) ADJ3597904 (VNO 0529502)
Regular
Nov 14, 2011

EMILIA OLGUIN vs. ESIS DIVISION OF ACE/USA INSURANCE; Permissibly Self-Insured

The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for reconsideration and dismissed the applicant's petition. The defendant argued that the WCJ's order to pay the EDD lien would result in undue enrichment due to prior payments, but the WCAB adopted the WCJ's reasoning that the defendant was on notice of the EDD's lien and paid benefits at its own peril. The applicant's petition was dismissed as untimely. The WCAB denied the defendant's petition, finding no error in the original award ordering payment of the EDD lien.

Workers' Compensation Appeals BoardIndustrial InjuryCervical SpineElbowsCumulative TraumaPsychological SystemPermanent DisabilityApportionmentEDD LienPetition for Reconsideration
References
Case No. ADJ11229680
Regular
Oct 13, 2025

BEATRIZ MACIAS vs. COUNTY OF LOS ANGELES SHERIFF'S DEPARTMENT, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

Applicant Beatriz Macias (deceased) sought reconsideration of a Findings of Fact and Award (F&A) that found her 100% permanently disabled but applied credits for earnings, temporary disability, and Labor Code section 4850 benefits. The defendant argued the credit was appropriate to prevent double recovery. The Appeals Board granted reconsideration, determining that the WCJ improperly allowed credits for temporary disability indemnity, salary, or section 4850 benefits, as permanent disability compensates for physical loss and lost earning capacity, distinct from temporary disability. Consequently, the F&A was amended to permit credit solely for permanent disability paid and reasonable attorney fees, with the remainder of the F&A affirmed.

Workers' Compensation Appeals BoardDeputy SheriffMetastatic Breast CancerUlnar Nerve InjuryPermanent Total DisabilityPetition for ReconsiderationLabor Code Section 4850Temporary Total DisabilityPermanent Disability IndemnityCredit for Benefits Paid
References
Case No. SJO 0254875
Regular
Jun 03, 2008

KIMBERLEY A. TURNER vs. BLOSSOM RIDGE MEDICAL GROUP, PREFERRED EMPLOYERS INSURANCE GROUP

This case involves an employer's petition for reconsideration of an award of additional temporary disability benefits (TDI) for an applicant's low back injury. The Appeals Board granted reconsideration to modify the award, requiring withholding of funds to satisfy a potential Employment Development Department (EDD) lien for overlapping state disability indemnity benefits. The Board affirmed the underlying award of TDI, ruling the employer was liable for 104 weeks of benefits from the date TDI first commenced.

Petition for ReconsiderationTemporary Total DisabilityOrder Terminating Temporary DisabilityPetition to ReopenEmployment Development DepartmentState Disability IndemnityNewly Discovered EvidencePetition for Reconsideration SubstituteBenefit PrintoutHawkins v. Amberwood Products
References
Case No. ADJ9888698 ADJ9888716
Regular
Jun 19, 2017

YI HE vs. MANDARIN CHINESE FOOD AND SUSHI, AMTRUST SAN DIEGO

The Workers' Compensation Appeals Board granted reconsideration and affirmed an order reinstating a Compromise and Release settlement. The defendant sought to deduct additional permanent disability advances beyond what was initially approved, claiming a mutual mistake. However, the Board found the discrepancy to be a unilateral mistake by the defendant, who drafted the agreement and failed to prove applicant's knowledge or exploitation of the error. Consequently, the Board ordered the reinstatement of the original settlement, amended only to correct a clerical omission of a case number.

Permanent Disability AdvancesCompromise and ReleaseUnilateral MistakeReconsiderationWorkers' Compensation Appeals BoardRescission of ContractEquitable CreditUnjust EnrichmentOrder Approving Compromise and ReleasePetition for Reconsideration
References
Case No. ADJ2736713 (VNO 0375817)
Regular
Nov 12, 2009

WILLIAM AVRIT vs. CALIFORNIA DEPT OF CORRECTIONS, SCIF STATE EMPLOYEES

The WCAB reversed the WCJ's order of restitution, finding that the WCJ lacked statutory authority to award reimbursement and that the equities did not favor SCIF's claim for reimbursement due to transactional stability.

Nations Surgery CenterSCIFrestitutionoverpaymenttransactional stabilityequitable reliefLabor Code section 4625lien claimantmedical treatment chargesunjust enrichment
References
Case No. ADJ6937895
Regular
Jan 29, 2014

OSVALDO CALLEROS vs. EL CHOLO CAFÉ, EVEREST NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded an order dismissing a lien claimant's lien. Although the lien claimant missed a conference and filed an objection late, the Board found that the treatment was authorized by the defendant and that returning the matter to the trial level would achieve substantial justice. The Board emphasized the public policy favoring disposition of cases on their merits, and that returning the case would allow for fair and equitable resolution without substantial prejudice to the defendant.

Lien ClaimantReconsiderationOrder Dismissing LienEquitableUnjust EnrichmentAuthorized TreatmentLien ConferenceNotice of Intention to DismissObjectionSubstantial Justice
References
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